Nursing Theories Quiz

Theoretical Frameworks for Nursing

• Objectives include discussing population shifts, cultural diversity, disease patterns, technology, and economic changes impacting healthcare and nursing practice.
• Objectives also include discussing important leaders and events impacting nursing practice.
• Objectives further include describing the four metaparadigm concepts of nursing and examining the influence of nursing theories on nursing practice.

A History of Health Care and Nursing

• Classical era (around 1000 BC): Healing linked to good and evil.
• Roman era (31 BC to AD 476): Galen and the Romans.
• Greek era (around 460-370 BC): Hippocrates.
• Middle Ages (AD 476-1453): Nursing influenced by Christianity.

A History of Health Care and Nursing (cont.)

• Renaissance (1473-1500s): Arts and science.
• Dark Period of Nursing (1500-1860): Worst period for nursing.
• Reformation (from 1517): Nursing care decline.
• Industrial Revolution (mid 1700s): Machinery and mass production.

And Then There Was Nightingale...

• Crimean experience: Florence Nightingale and sanitation.
• Nightingale as a political reformer.
• Military reforms.
• Nightingale School of Nursing.
• Taking health care to the community.
• Nightingale's legacy.

Definitions

• Concept: Describes a phenomenon.
• Conceptual model: A set of concepts and statements.
• Propositions: Statements describing relationships.
• Assumptions: Describe concepts or connect two concepts representing values, beliefs, or goals.
• Theory: An organized, coherent, and systematic articulation of a set of statements, communicated in a meaningful whole.
• Metaparadigm: Global perspective of a discipline.

Nightingale's Environmental Theory

• Metaparadigm concepts: Person, environment, health, nursing.
• Person: Recipient of nursing care.
• Environment: External (temperature, bedding) and internal (food, water, and medications)
• Health: Using all powers to be well.
• Nursing: Altering or managing the environment to maintain health.
• Nightingale's 13 canons.

Nightingale's Theory- Environment

• Descriptors of the environment to create optimal health outcomes. Includes elements like ventilation, hygiene, light, and nutrition.

Team Activity

• A team-based activity involving a group of nursing students. Names and possible group affiliations of students are included, but not essential for nursing study.

Basic Patient Scenario

• A patient scenario involving a patient with pneumonia and pre-diabetes.
• Nursing theory application is requested.

Virginia Henderson: Definition of Nursing and 14 Components of Care

• 1960s metaparadigm concepts.
• Person: Biological, psychological, sociological, and spiritual components.
• Environment: External environment.
• Health: Patient's ability to function independently.
• Nursing: Assisting the person, sick or well, in performing activities.
• Henderson's 14 basic needs.

Virginia Henderson- Nursing Need

• Theory developed by Virginia Henderson to define nursing practice.
• Focus on increasing patient independence in hospital settings.
• Emphasizes basic human needs and nursing assistance.

Jean Watson: Philosophy and Science of Caring

• Metaparadigm Concepts: Person, healing space/environment, health/healing, nursing.
• Person: Unity of mind-body-spirit; embodied spirit.
• Healing space/environment: Nonphysical energetic environment; the nurse is the environment.
• Health/healing: Harmony, wholeness, comfort.
• Nursing: Reciprocal transpersonal relationship caring guided by caritas.
• Goal: Help people attain harmony in mind, body, and spirit.
• Goal achieved through transpersonal caring guided by 10 caritas processes.

Jean Watson- Caring

• Caring process diagram depicting various elements including values and goals of patient care.

Patricia Benner's Clinical Wisdom in Nursing Practice

• 7 domains of nursing.
• 5 stages of skill acquisition.
• 6 aspects of clinical judgment and skilled comportment (reasoning-in-transition, skilled know-how, agency, perceptual acuity, skill of involvement, links between clinical and ethical reasoning).
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: Embodied person living in the world; self-interpreting being.
• Environment: Social environment with social meaningfulness.
• Health: Human experience of health or wholeness.
• Nursing: Caring relationship, study of lived experience.

Patricia Benner- Clinical Wisdom

• Describes stages of clinical proficiency, from novice to expert.

Martha Rogers's Science of Unitary Human Beings

• Metaparadigm concepts: Person, environment, health, nursing.
• Person: Irreducible, irreversible, pandimensional, negentropic energy field.
• Environment: Irreducible, pandimensional, negentropic energy field.
• Health: Continuum of wellness and illness.
• Nursing: Promote symphonic interaction between human and environmental fields.
• Principle of Homeodynamics, Helicy, Resonance, Integrality.

Martha Rogers- Unitary Human Beings

• Image of the human as a complex energy field interacting with the environment.

Martha Rogers Interview Videos

• Two video links provided.

Dorothea Orem's Self-Care Deficit Theory of Nursing

• Theory of Self-Care: Universal, developmental, and health-deviation requisites.
• Theory of Self-Care Deficit: Diagnostic, prescriptive, regulatory, and control operations.
• Theory of Nursing Systems: Wholly compensatory, partially compensatory, supportive-educative systems.
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: Under the care of a nurse; total being with universal, developmental needs and capable of self care.
• Environment: Physical, chemical, biological, and social contexts within which human beings exist, development environment.
• Health: Soundness, wholeness, bodily and mental functioning.
• Nursing : Therapeutic self-care designed to supplement self-care requisites.

Dorothea Orem- Self Care

• Diagram of the conceptual framework of self-care theory. Includes self-care agency, self-care demands, conditioning factors, and nursing agency.

Callista Roy's Adaptation Model

• Metaparadigm concepts: Person, environment, health, nursing.
• Person: A whole with parts, a human system.
• Environment: Internal and external stimuli.
• Health: A state and process of becoming an integrated, whole human being.
• Nursing: Manipulation of stimuli to foster successful adaptation.
• Roy's six-step nursing process: Assessing behaviors, categorizing stimuli, creating nursing diagnosis, establishing goals for adaptation, implementing interventions, and evaluating adaptation goals.

Roy's Adaptation Model

• Diagram depicting human adaptive systems related to stimuli, coping processes, and behavior.

Betty Neuman's Systems Model

• Client system protected by a circular series of buffers (lines of defense): flexible line of defense, normal line of defense, lines of resistance.
• Metaparadigm concepts: Person, environment, health, nursing.
• Person (client system): Composite of physiological, psychological, sociocultural, developmental, and spiritual variables.
• Environment: All internal and external factors of influence.
• Health: Continuum of wellness to illness, optimal system stability.
• Nursing: Prevention as intervention, concerned with potential stressors.

Betty Neuman- Lines of Defense

• Diagram showing the central core, flexible and normal lines of defense, and lines of resistance in the system model.

Imogene King's Interacting Systems Framework

• Personal systems (bodily image, growth, perception, self, space, time).
• Interpersonal systems (communication, interaction, role, stress, transaction).
• Social systems (authority, decision making, organization, power, status).

Imogene King's Theory of Goal Attainment

• Goal attainment: Assessment focuses on patient, nurse perceptions, communication, and interaction.
• Planning: Deciding on goals.
• Implementation: Focusing on transactions made.
• Evaluation: Evaluating achieved goals.
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: Personal system interacting with interpersonal and social systems.
• Environment: External and internal context; daily activities.
• Health: Dynamic experience reflecting adjustment and potential.
• Nursing: Helping patients achieve their goals through human interaction.

Imogene King- Goal Attainment

• Diagram of goal attainment theory, showing the heart shape with interconnected elements.

Johnson's Behavioral System Model

• Metaparadigm concepts: Person, environment, health, nursing.
• Person (human being): A biopsychosocial being.
• Environment: Internal and external influences.
• Health: Efficient and effective system functioning, behavioral system balance and stability.
• Nursing: External regulatory force maintaining patient behavior at an optimal level.
• Seven subsystems of behavior.
• Johnson's nursing diagnostic approach.

Johnson- Behavioral System

• Diagram of the behavioral system model, including various subsystems connecting to the concept of behavior. Includes forces and stress.

Rosemarie Parse's Humanbecoming Theory

• Three themes: Meaning, rhythmicity, transcendence.
• Metaparadigm concepts: Person, environment, health, nursing.
• Person: An open being, distinct from parts.
• Environment: Coexists with the person in a mutual process.
• Health: Continuously changing process of becoming in the context of uncertainty.
• Nursing: Using true presence to facilitate becoming of the person.

Rosemarie Parse- Human Becoming

• Diagram of the human becoming theory, showing interconnected concepts (e.g., meaning, rhythmicity, transcendence).

Madeleine Leininger's Cultural Diversity and Universality Theory

• Three modalities: preserving/maintaining, accommodating/negotiating, repatterning/restructuring cultures.
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: Human beings, families, communities, institutions.
• Environment: Totality of experiences in diverse settings.
• Health: Culturally defined and practiced well-being.
• Nursing: Activities congruent with cultural values.

Madeleine Leininger- Transcultural Nursing

• Diagram depicting factors influencing nursing practice, including cultural, religious, and social contexts.

Hildegard Peplau's Theory of Interpersonal Relations

• Four phases (orientation, identification, exploitation, resolution).
• Six roles (teacher, resource, counselor, leader, technical expert, surrogate).
• Metaparadigm concepts: Person, environment, health, nursing.
• Person: Patient who requires assistance, and the nurse.
• Environment: Forces outside the organism within the context of culture.
• Health: Implies forward movement of personality, in terms of creativity, constructive thinking.
• Nursing: Therapeutic interpersonal process between nurse and the patient.

Hildegard Peplau- Interpersonal Relationships

• Venn diagram illustrating contributing factors to effective interpersonal relations in the nurse-patient orientation phase, highlighting values, culture, beliefs, past experiences, preconceived ideas on both the nurse and patient sides.

Nola Pender's Health Promotion Model

• Major categories: Individual characteristics, behavior-specific cognitions/affect, behavioral outcomes.
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: The individual.
• Environment: Physical, interpersonal, and economic circumstances.
• Health: A positive high-level state.
• Nursing: Actions focusing on raising consciousness, encouraging self-efficacy, supporting positive changes, and managing barriers.

Nola Pender- Health Promotion

• A circular diagram highlighting aspects of wellness including physical, environmental, social, emotional, and spiritual well being.

Afaf Ibrahim Meleis's Transitions Theory

• Transition process triggered by change.
• Transition types: Developmental, health and illness, situational, organizational.
• Metaparadigm Concepts: Person, environment, health, nursing.
• Person: Active beings experiencing fundamental life patterns and attaching meaning to transition experience.
• Environment: Context that impacts health and well-being related to the transition process.
• Health: Health is considered a state of well-being that implies continuous adjustment.
• Nursing: Involves providing care and support during different transitions to foster healthy outcomes.

Afaf Ibrahim Meleis- Transitions

• Diagram depicting transition types, patterns, conditions, properties, therapeutics, and response patterns.

Kristen Swanson's Theory of Caring

• Five basic processes of caring: Maintaining belief, knowing, being with, doing for, enabling.
  • Metaparadigm concepts: Person, environment, health, nursing.
• Person: Unique beings in the midst of becoming, wholeness reflected in feelings, thoughts, behaviors.
• Environment: Any context influencing or influenced by the client.
• Health: Subjective, meaningful experience of wholeness, integration and becoming.
• Nursing: Informed and informed caring for the well-being of others.

Kristen Swanson-Caring

• Diagram that visually represents the structure of caring through different components linked to the client, the involved nurse, and the outcome.

Katharine Kolcaba's Theory of Comfort

• Three contexts of comfort: physical, psychospiritual, sociocultural.
• Three components of comfort care: appropriate intervention, delivery mode (caring and empathy), and intent to comfort.
• Metaparadigm Concepts: Person, environment, health, nursing
• Person: Individuals, Families, Institutions and communities.
• Environment: Any aspect of the patient's, family, or institution that helps in enhancing comfort.
• Health: Optimal function of the patient, family, or healthcare provider.
• Nursing: Intentional assessment of comfort needs, intervention, and reassessment.

Pamela Reed's Self-Transcendence Theory

• Three major concepts: self-transcendence, well-being, vulnerability.
• Metaparadigm concepts: Person, environment, health, nursing.
• Person: Human beings developing over lifespan, through interpersonal interactions within environments.
• Environment: Comprised of family, social network, physical surroundings, community resources.
• Health: A sense of wholeness and well-being.
• Nursing: Assisting persons in promoting health and well-being through interpersonal processes.

Merle Mishel's Uncertainty in Illness Theory

• Three major themes: Antecedents of uncertainty, appraisal of uncertainty, coping with uncertainty.
• Metaparadigm concepts: Person, environment, health, Nursing.
• Person: An individual, or family whose experience involves uncertainty related to the illness.
• Environment: Forces outside the organism, a factor in the experience of uncertainty.
• Health: Associated with uncertainty experienced in the illness.
• Nursing: Focused on supporting the patient experience and helping deal with uncertainty during the experience of illness.

Cheryl Tatano Beck's Postpartum Depression Theory

• Two major concepts: Postpartum mood disorders and loss of control.
• Four stages in the coping process.
• Metaparadigm concepts: Person, environment, health, nursing.
• Person: Individuals described in terms of wholeness, including biological, sociological, and psychological aspects.
• Environment: Individual and external factors are viewed broadly.
• Health: Traditional ideas about physical and mental health are considered within the context of the women's responses.
• Nursing: A caring profession promoting health and wholeness through interpersonal interaction.

The American Association of Critical-Care Nurses Synergy Model for Patient Care

• Eight patient characteristics and eight nurse characteristics.
• Three levels of outcomes.
• Metaparadigm concepts: Person, environment, health, and nursing
• Person: Individual is viewed in relation to biological, social, and spiritual contexts, and developmental stage.
• Environment: Created by nurses for the patient's care.
• Health: Ideal level of wellness.
• Nursing: Meet patients' needs.

Overview of Selected Non-Nursing Theories

• General systems theory (Von Bertalanffy).
• Social cognitive theory (Bandura).
• Stress and coping process theory (Lazarus).
• General adaptation syndrome (Selye).

Relationship of Theory to Professional Nursing Practice

• Consider values and beliefs
• Create philosophy of nursing related to person, environment, health, and nursing practice.
• Survey definitions and models of person, environment, health, and nursing.
• Select 2-3 frameworks, review assumptions, make applications to specific areas of nursing practice.
• Compare frameworks on focus, nursing action, and client outcome
• Review nursing literature by those who've used these frameworks.
• Select a framework and develop its implementation in your nursing practice.

Test your knowledge on various nursing theories and models including Johnson's Behavioral System Model, Parse's Humanbecoming Theory, and Betty Neuman's Systems Model. This quiz covers key concepts related to health, the environment, and the roles of nursing according to different theoretical frameworks.